Indiana 2023 Regular Session

Indiana Senate Bill SB0371 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2	Introduced Version
3	3	SENATE BILL No. 371
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 12-15-5-14; IC 25-23-1.
7	7	Synopsis: Advanced practice registered nurses. Amends the hospital
8	8	governing board requirements for the manner in which a psychiatric
9	9	mental health advanced practice registered nurse will interact with
10	10	other practitioners. Requires the Indiana state board of nursing to
11	11	provide a report to the general assembly concerning psychiatric mental
12	12	health advanced practice registered nurses who practice without a
13	13	practice agreement. Makes conforming changes.
14	14	Effective: Upon passage; July 1, 2023.
15	15	Ford Jon
16	16	January 19, 2023, read first time and referred to Committee on Health and Provider
17	17	Services.
18	18	2023 IN 371—LS 7205/DI 148 Introduced
19	19	First Regular Session of the 123rd General Assembly (2023)
20	20	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
21	21	Constitution) is being amended, the text of the existing provision will appear in this style type,
22	22	additions will appear in this style type, and deletions will appear in this style type.
23	23	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
24	24	provision adopted), the text of the new provision will appear in this style type. Also, the
25	25	word NEW will appear in that style type in the introductory clause of each SECTION that adds
26	26	a new provision to the Indiana Code or the Indiana Constitution.
27	27	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
28	28	between statutes enacted by the 2022 Regular Session of the General Assembly.
29	29	SENATE BILL No. 371
30	30	A BILL FOR AN ACT to amend the Indiana Code concerning
31	31	health.
32	32	Be it enacted by the General Assembly of the State of Indiana:
33	33	1 SECTION 1. IC 12-15-5-14, AS AMENDED BY P.L.129-2018,
34	34	2 SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
35	35	3 JULY 1, 2023]: Sec. 14. (a) As used in this section, "advanced practice
36	36	4 registered nurse" means:
37	37	5 (1) a nurse practitioner; or
38	38	6 (2) a clinical nurse specialist;
39	39	7 who is a registered nurse licensed under IC 25-23 and qualified to
40	40	8 practice nursing in a specialty role based upon the additional
41	41	9 knowledge and skill gained through a formal organized program of
42	42	10 study and clinical experience, or the equivalent as determined by the
43	43	11 Indiana state board of nursing.
44	44	12 (b) As used in this section, "office" includes the following:
45	45	13 (1) The office of the secretary of family and social services.
46	46	14 (2) A managed care organization that has contracted with the
47	47	15 office of Medicaid policy and planning under this article.
48	48	16 (3) A person that has contracted with a managed care organization
49	49	17 described in subdivision (2).
50	50	2023 IN 371—LS 7205/DI 148 2
51	51	1 (c) The office shall reimburse eligible Medicaid claims for the
52	52	2 following services provided by an advanced practice registered nurse
53	53	3 employed by a community mental health center if the services are part
54	54	4 of the advanced practice registered nurse's scope of practice:
55	55	5 (1) Mental health services.
56	56	6 (2) Behavioral health services.
57	57	7 (3) Substance abuse treatment.
58	58	8 (4) Primary care services.
59	59	9 (5) Evaluation and management services for inpatient or
60	60	10 outpatient psychiatric treatment.
61	61	11 (6) Prescription drugs.
62	62	12 (d) The office shall include an advanced practice registered nurse
63	63	13 as an eligible provider for the supervision of a plan of treatment for a
64	64	14 patient's outpatient mental health or substance abuse treatment
65	65	15 services, if the supervision is in the advanced practice registered
66	66	16 nurse's scope of practice, education, and training.
67	67	17 (e) This section:
68	68	18 (1) may not be construed to expand an advanced practice
69	69	19 registered nurse's scope of practice; and
70	70	20 (2) is subject to IC 25-23-1-19.4(c). and applies only if the service
71	71	21 is included in the advanced practice registered nurse's practice
72	72	22 agreement with a collaborating physician.
73	73	23 SECTION 2. IC 25-23-1-19.4, AS AMENDED BY P.L.127-2020,
74	74	24 SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
75	75	25 JULY 1, 2023]: Sec. 19.4. (a) This section does not apply to certified
76	76	26 registered nurse anesthetists.
77	77	27 (b) As used in this section, "practitioner" has the meaning set forth
78	78	28 in IC 16-42-19-5. However, the term does not include the following:
79	79	29 (1) A veterinarian.
80	80	30 (2) An advanced practice registered nurse.
81	81	31 (3) A physician assistant.
82	82	32 (c) Except as provided in subsection (f), an advanced practice
83	83	33 registered nurse shall operate:
84	84	34 (1) in collaboration with a licensed practitioner as evidenced by
85	85	35 a practice agreement;
86	86	36 (2) by privileges granted by the governing board of a hospital
87	87	37 licensed under IC 16-21 with the advice of the medical staff of the
88	88	38 hospital that sets forth the manner in which an advanced practice
89	89	39 registered nurse and a licensed practitioner will cooperate,
90	90	40 coordinate, and consult with each other in the provision of health
91	91	41 care to their patients; or
92	92	42 (3) by privileges granted by the governing body of a hospital
93	93	2023 IN 371—LS 7205/DI 148 3
94	94	1 operated under IC 12-24-1 that sets forth the manner in which an
95	95	2 advanced practice registered nurse and a licensed practitioner will
96	96	3 cooperate, coordinate, and consult with each other in the
97	97	4 provision of health care to their patients.
98	98	5 (d) This subsection applies for purposes of the Medicaid program
99	99	6 to an advanced practice registered nurse who:
100	100	7 (1) is licensed pursuant to IC 25-23-1-19.5; and
101	101	8 (2) has been educated and trained to work with patients with
102	102	9 addiction and mental health needs.
103	103	10 An advanced practice registered nurse who meets the requirements of
104	104	11 this subsection has all of the supervisory rights and responsibilities,
105	105	12 including prior authorization, that are available to a licensed physician
106	106	13 or a health service provider in psychology (HSPP) operating in a
107	107	14 community mental health center certified under IC 12-21-2-3(5)(C).
108	108	15 (e) Before January 1, 2021, the office of the secretary shall apply to
109	109	16 the United States Department of Health and Human Services for any
110	110	17 state plan amendment necessary to implement subsection (d).
111	111	18 (f) A psychiatric mental health advanced practice registered
112	112	19 nurse with prescriptive authority may practice without a practice
113	113	20 agreement if the following conditions are met:
114	114	21 (1) The psychiatric mental health advanced practice
115	115	22 registered nurse has practiced under a practice agreement
116	116	23 with a practitioner for the full-time equivalent of at least one
117	117	24 (1) year.
118	118	25 (2) The practitioner described in subdivision (1) has been
119	119	26 licensed in Indiana for a minimum of five (5) years with the
120	120	27 practitioner's respective governing board.
121	121	28 (3) The practitioner has reviewed at least five percent (5%) of
122	122	29 the psychiatric mental health advanced practice registered
123	123	30 nurse's prescriptive charts during the practice agreement
124	124	31 period.
125	125	32 (4) The psychiatric mental health advanced practice
126	126	33 registered nurse has submitted an attestation to the board to
127	127	34 the completion of the required one (1) year practice
128	128	35 agreement.
129	129	36 (5) The psychiatric mental health advanced practice
130	130	37 registered nurse practices in the same practice area in which
131	131	38 the psychiatric mental health advanced practice registered
132	132	39 nurse practiced with the practitioner under a practice
133	133	40 agreement.
134	134	41 (6) The psychiatric mental health advanced practice
135	135	42 registered nurse establishes a referral plan to other
136	136	2023 IN 371—LS 7205/DI 148 4
137	137	1 appropriate practitioners for complex medical cases, medical
138	138	2 emergencies, and cases that are beyond the psychiatric mental
139	139	3 health advanced practice registered nurse's scope of practice.
140	140	4 The board shall designate on the psychiatric mental health
141	141	5 advanced practice registered nurse's prescriptive authority license,
142	142	6 in a manner determined by the board, that the psychiatric mental
143	143	7 health advanced practice registered nurse has completed the
144	144	8 requirements of this subsection.
145	145	9 (g) If a psychiatric mental health advanced practice registered
146	146	10 nurse practices independently without a practice agreement, the
147	147	11 psychiatric mental health advanced practice registered nurse shall
148	148	12 notify patients, through posting in a prominent and conspicuous
149	149	13 place, that the psychiatric mental health advanced practice
150	150	14 registered nurse is practicing independently.
151	151	15 SECTION 3. IC 25-23-1-19.6, AS AMENDED BY P.L.28-2019,
152	152	16 SECTION 14, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
153	153	17 JULY 1, 2023]: Sec. 19.6. (a) When the board grants authority to an
154	154	18 advanced practice registered nurse to prescribe legend drugs under this
155	155	19 chapter, the board shall assign an identification number to the
156	156	20 advanced practice registered nurse.
157	157	21 (b) An advanced practice registered nurse who is granted authority
158	158	22 by the board to prescribe legend drugs must do the following:
159	159	23 (1) Enter on each prescription form that the advanced practice
160	160	24 registered nurse uses to prescribe a legend drug:
161	161	25 (A) the signature of the advanced practice registered nurse;
162	162	26 (B) initials indicating the credentials awarded to the advanced
163	163	27 practice registered nurse under this chapter; and
164	164	28 (C) the identification number assigned to the advanced
165	165	29 practice registered nurse under subsection (a).
166	166	30 (2) Transmit the prescription in an electronic format for an
167	167	31 electronically transmitted prescription.
168	168	32 (3) Comply with all applicable state and federal laws concerning
169	169	33 prescriptions for legend drugs, including the requirement to issue
170	170	34 electronically transmitted prescriptions under IC 25-1-9.3.
171	171	35 (c) An advanced practice registered nurse may be granted authority
172	172	36 to prescribe legend drugs under this chapter only within the scope of
173	173	37 practice of the advanced practice registered nurse and, if applicable,
174	174	38 the scope of the licensed collaborating health practitioner.
175	175	39 SECTION 4. [EFFECTIVE UPON PASSAGE] (a) Before July 1,
176	176	40 2026, the Indiana state board of nursing shall report to the general
177	177	41 assembly in an electronic format under IC 5-14-6 the following
178	178	42 information concerning psychiatric mental health advanced
179	179	2023 IN 371—LS 7205/DI 148 5
180	180	1 practice registered nurses who practice without a practice
181	181	2 agreement:
182	182	3 (1) The number who have been authorized to practice without
183	183	4 a practice agreement.
184	184	5 (2) The geographic practice areas.
185	185	6 (3) The medical population practice areas.
186	186	7 (4) A summary of disciplinary actions taken.
187	187	8 (b) This SECTION expires December 31, 2026.
188	188	9 SECTION 5. An emergency is declared for this act.
189	189	2023 IN 371—LS 7205/DI 148